Wednesday, October 07, 2020

Great Barrington Declaration

 This is really a job for twitter but that's not my platform.

Great Barrington Declaration

I've signed.

Peter

76 comments:

jeangenie said...

Thank you for this. I've signed and shared on Facebook

Eric said...

I am not convinced, unfortunately. The declaration paints the picture of total lockdown vs. no restrictions except for the elderly and vulnarable. But that is not the dichotomy we should be facing. The alternative is really limited restrictions vs. no restrictions.

If you had asked me in mid August, I would probably have agreed. But now, infections (as detected by PCR*), hospitalizations, ICU admissions and deaths are creeping up left and right. Stockholm, where Covid was over as declared by Dr. Sebastian Rusworth on Sept 19th in Malcolm's blog, infection rates are currently well above the threshold of 50 / 100,000 and week, and there are worries about ICUs filling up. So neither was it over nor has herd immunity arrived there. Neither has it in France, in Spain or in New York.

The economy is a mess even in countries that had no proper lockdown like Sweden or most of the US, actually, most of all in the US. I can see how a lockdown will lead to less medical care for other illnesses, but so will a ramant infection rate - people will be afraid either way. I can also see that a poor economy will lead to additional suffering, but neither total lockdown nor no restrictions seem to work. And looking at excess mortality data

https://github.com/TheEconomist/covid-19-excess-deaths-tracker

or for a good graphic representation, scroll down to "Übersterblichkeit"
https://www.spiegel.de/wissenschaft/medizin/coronavirus-infizierte-genesene-tote-alle-live-daten-a-242d71d5-554b-47b6-969a-cd920e8821f1

show that for a number of European countries, excess mortality matches Covid deaths extremely closely. Accounting for undetected cases, this means non-Covid mortality has acutually gone down.

I think trying to approach herd immunity is sensible, but not in an uncontrolled way. It appears you see more serious cases when people are exposed to large doses of infectious particles, such as caring for patients without proper PPE or spending a night in a pub or club without a mask.

On the other hand, getting exposed while distancing and wearing a mask may lead to acquired immunity.

Eric said...

On a lighter note, there have been proposals to eliminate all plosives and frictives from our language:

https://www.plaf.org/articles/la_phonetique_du_postillon/

https://www.youtube.com/watch?v=2G8pNPcRm38

https://www.youtube.com/watch?v=pSGav4y2Oio

ctviggen said...

My issue is that I've always been a scientist, and I think as a scientist, there are only theories. The goal is to determine whether studies support those theories or not.

And I can say confidently that after almost 7 years low carb/keto, I know less now than I did when I started. For instance, I tried a version of Brad's (Fire in a Bottle's) high sat fat diet. The good news was that if I ate a ton of saturated fat, I did experience a marked decrease in hunger. The bad news was that I gained 15+ pounds, all in my belly. And, to get any type of decrease in hunger, I had to eat a TON of saturated fat. Otherwise, it didn't work. There's only so much ghee+cacao butter+stearic acid one can eat before you want to eat real food.

As with all N=1 studies, it's not possible to change just one variable, so I can't directly attribute this ONLY to sat fat, but it's unclear how the theory works in real people.

Not to mention I was in a Twitter conversation where other people (all men) tried the high sat fat diet, and we all gained weight. But we were also low carb for years, so perhaps it works less when you have less PUFA in your fat?

Applying that to the pandemic, I find many issues that aren't clear. For instance, one theory is that because there is cross-reactivity between people with common cold corona viruses and covid-19, we don't need as high of a number of people to get infected before we reach "herd immunity".

But if you listen to this:

https://www.microbe.tv/twiv/twiv-657/

They interview an MIT alum who studied cross-reactivity using frozen blood from pre-pandemic days. This person's job is to study viruses and the effects of vaccines. He has several papers out, where he shows there is cross-reactivity between common-cold coronaviruses and covid-19. But he says he does not know what this means. It could even be bad (it's bad in other viruses/diseases). He doesn't think it is, but he's not sure.

I know we're all anti-establishment, as we're viewing things much differently than the "establishment", but I don't think this applies at all times. If a guy who went to MIT and does nothing but study viruses and vaccines says "I don't know" about something, why should we say we do know? All we have are theories.

And you can always find a different opinion about things. Here's another about that "magical" location, Sweden:

https://www.sciencemag.org/news/2020/10/it-s-been-so-so-surreal-critics-sweden-s-lax-pandemic-policies-face-fierce-backlash

From my perspective, if your answer about anything isn't "It's complex" or "I THINK it's like this, but this is only one possibility", then I think you're wrong. I have stopped following so many low carb gurus on Twitter because of this. In fact, this has shaken my belief in them so much, that I no longer can tell whether anything else they said is true. I now will have to perform the research myself.

Anyway, "lunch" (first meal of the day) is over, and I have to get back to work.

Eric said...

I know we're all anti-establishment, as we're viewing things much differently than the "establishment", but I don't think this applies at all times. If a guy who went to MIT and does nothing but study viruses and vaccines says "I don't know" about something, why should we say we do know?

*** Exactly my sentiment, and actually the issue I have had for a while with Malcolm's blog and especially now, that it is overrun with folks who are anti-everything and will ridicule most attempts at a measured discourse.

From my perspective, if your answer about anything isn't "It's complex" or "I THINK it's like this, but this is only one possibility", then I think you're wrong.

*** And this is what bothers me about the declaration. It is very hard to make sense of the data coming in from various countries and compare them to how their numbers were historically and what restrictions were in place at what time.

Telling people to mingle without a mask and get infected asap and with no consideration to dose as Malcolm has done might be inviting serious trouble, and the declaration is not so far from what he said.

Gyan said...

If one studies any virus or illness in extreme detail then one will find plenty of "I don't knows". Even common cold has mysteries--I get pain in one eye for one day, and pain in the other eye the next day.

What is uncommon is that the normal puzzles of research are taken to imply a permanent emergency and permanent restrictions.

Eric said...

ICU cases and fatalities are creeping up everywhere in Europe, and considering that we now have more widespread testing, the average age of the infected is lower and treatment has gotten better, the apparent infection fatality rate is still disconcertingly high.

Also, we don't know the makeup (age, co-morbidities) of those currently fighting a servere infection. All I have found is a doctor from Paris saying a third of those in ICU are currently under 65.

Stefan said...

Don't they always creep up in the fall? So far, mortality and ICU cases in Holland seem to be in the normal range. If it stays that way, I don't really see why people should focus so much on Covid. Other years the issue was with influenza, now it has a different label. Biggest difference to me are all the restrictions. We've never had that before.

Unknown said...

ctviggen, I'd be interested to know more about your version of Brad's high sat fat diet where you gained weight. What were your macronutrient ratios? What does your regular diet look like?

Robin

Peter said...

Hi jeangenie, cool

Eric, sadly my French is not up to the video and my German is non existent! More seriously we all have to make our own decisions. That’s good. Having Bojo make them for me is less appealing.

ctviggen, I have long wondered if the correct strain of common cold virus is a pre existing vaccine. Perhaps find it and get it out in to society and hey presto… But I have no idea how many 85 year old diabetics would normally die from a common cold infection… And yes, articles critical of Sweden are widely available. Plenty of choice for everyone!

Stefan, yep. Plus our local hospital will routine run out of mortuary facilities in a bad flu year. They’ve had to bring in refrigerated trucks as a temporary fix before now.

Peter

Gyan said...

WHO last week estimated that 10 percent of the world population has been infected by covid.
That gives infection fatality ratio of 0.14 percent -- same order as flu.

Peter said...

Gyan, that's nice.

Peter

LeenaS said...

Well, it would be nice. However, that cannot be right. Taking the infection rate from an estimate and the occurred fatalities from tabulated numbers is like comparing apples with oranges. And, this is not even over as of yet.

Cheers,
LeenaS

Gyan said...

Infections are estimated from sero-surveys. I haven't come across any doubts regarding them.

LeenaS said...

Yes, but the deaths reported are not same as the deaths estimated. There seems to be quite many "excess deaths" even in some depeloped countries, and then there are countries which claim that no covid was ever found there. The true estimate on covid deaths for the whole earth population may be hard to find.

Peter said...

And I would just comment that serological surveys will markedly under estimate prevalence. Many ITU survival patients have antibody counts below assay limits.

Peter

Eric said...

@Peter: my lighter note links were about replacing all offending (as in droplet generating) consonants such as P, B with M, D, T with N, K and the hard G with soft GN, F, V, S, Z with soft J. The result is absolutely hilarious in French and German. I tried finding something in English but didn't come up with anything.

Back to Barrington, I know it has something of "if my enemy supports it, it must be bad", but I found it interesting nonetheless that a think tank founded by the Koch brothers was where it happened:
https://www.theguardian.com/commentisfree/2020/oct/11/the-rebel-scientists-cause-would-be-more-persuasive-if-it-werent-so-half-baked

Since we have ventured into politics: I would also bristle at BJ making decisions for me, and maybe we are lucky that AM is relatively competent and inoffensive (never voted conservative in my life!), and any attempt at central decisions is tempered by our federal system (her trying to shepherd 15 male state prime ministers has been quite a circus.

But in the end, I suppose this is where Kantian philosophy applies, common good comes before individual freedom, i.e. mask wearing is about protecting the vulnerable, and if masks make for a slower and more controllable spread, that protects the vulnable, which is no longer possible with skyrocketing infection rates.

Here's yet another paper that shows that virus doses have been going down, and speculates that this is due to distancing and mask use:
https://www.eurekalert.org/pub_releases/2020-09/esoc-uss092320.php

Gyan said...

In India maximum daily deaths ascribed to covid were less than 4 percent of usual daily deaths.
It is quite likely that there were actually no excess deaths at all.
It is quite peculiar that with so much scientific expertise in the world, we still fail and fall to hysteria and over-reaction.

Peter said...

Eric,

Pity there is no translatability, we could probably all do with a laugh at the moment!

The politicisation is a real problem. However it is absolutely the case that if Johnson were to adopt the Barrington Declaration I would support such an approach whole heartedly. You have no idea how difficult I would find that emotionally. But I think it would be the correct approach. At the moment we have what is essentially the Swedish approach by virtue of the fact that our PM could not organise a piss-up in a brewery. But we currently have it combined with legally enforceable rule by fiat to make everyone suffer.

I love the mask paper. I like particularly

"A downward trend in the initial VL may reflect a reduction in the severity of the pandemic and trends in the viral load values over time may represent a marker to assess the progress of the pandemic".

Ad hoc hypothesis number 3224. Might well be correct, they are saying the pandemic is fading, certainly in temperate latitudes. The mask bit:

"Rapid implementation of social distancing measures, lockdown and widespread use of facemasks may have contributed to a decrease in the exposure to the virus."

is ad hoc hypothesis number 9327, probably mostly wrong.

Probably something between the two hypotheses might have some credibility. Someone should test them!

Peter

Eric said...

Peter, I can relate, as I have had to grudgingly admit that AM is not doing such a bad job occasionally.

I had come up with the viral load - severity and the mask - controlled viroalation (is that how you spell it?) hypotheses long before they became fashionable. I have read the report of the head of pneumology at Innsbruck university hospital about the cases of healthy divers after the Ischgl outbreak that he wrote for a German language diving magazine to get an incling of what a large dose of virus, such as from a drunken night in a bar, can do to very fit people.

Back to the declaration, the choice is not between no restrictions and severe lockdown really, it is between no and rather light restrictions. Only if we let it spiral out of control and ICUs are at capacity again will there be calls for a real lockdown again. I get the feeling that the UK and France are past the point where the infection rate can still be controlled, though. I can only hope that some background immunity has evolved by now and that the all out high dose exposures will not happen.

On a side note, does anyone understand why Thailand and Vietnam are doing so well? Can't be the sunlight, as e.g. Argentina is not faring so well.

Eric said...

Austrian article:
https://www.wetnotes.eu/wp-content/uploads/2020/04/Tauchen-nach-Covid-19-Erkrankung_WETNOTES-36.pdf

http://divemagazine.co.uk/skills/8907-serious-problems-diving-after-covid19

LeenaS said...

I read the declaration, but cannot sign it. Not after what actually happened last spring in Sweden. I see no political will whatsoever anywhere to focus on saving the vulnerable after what is being exposed there.

Shortly: Those accepted into municipal care system (where btw you cannot enter without medical conditions requiring physicians) were excluded from physicians and simple care, even testing. At least in the community of Stockholm, which is largest and where the Covid hit hardest. Some blood thinners and extra oxygen would have saved many, but those were not allowed, any more than masks for the care staff. And when they did get sick and die, the care staff was blamed, for months.
The article is behind paywall, sorry: https://www.dn.se/kultur/varfor-fick-de-aldre-do-utan-lakarvard/

This did not happen in other nordic countries (or Germany), where casualties stayed 10 times lower than in Sweden. Also here elderly took it hardest, but at least they were cared for, and most of them did survive.

I still remember the head of Swedish FHM saying to us: just wait, you shall have hard time in the fall, when we shall be all free of virus and all open. As it is, now Sweden has marginally harder restrictions than us; and they are taking the situation very, very seriously.

Eric said...

Leena, something is not adding up. Sebastian Rushworth, on Sept 19th, said Stockholm was virtually Corona free, when numbers began rising again. Just saw he was interviewed by Ivor Cummins on fatemperor, video was posted yesterday but haven't watched fully yet.

I have no clue how you can have a majority of the population already infected and then both CR and ICU admissions climbing again unless repeat infections are in fact possible and become severe in a significant percentage of people.

LeenaS said...

Eric, no kidding.
I've been following Swedish fatality numbers since the beginning, from worldometer as well as directly from the SVT national net pages. This fall they have not been equal any day, even though the total fatality number is.

And then, DN wrote about it, explaining. Sweden (unlike all the other northeners) puts every death on the actual time. So, the numbers increase but with time, in some weeks, meaning that it always looks as if things were clearing up. I'm not in politics and I do see that someone there may wish to explain, but I do not like this.
The DN article on it (sorry, once again paywalled): https://www.dn.se/debatt/svensk-coronastatistik-ger-en-skev-bild-av-smittspridningen/

The numbers (in fatalities as well as in infections) are on the rise, and most alarmingly Mt Tegnell warned that the virus has found its way to some carehomes. Again. So, the promise no Halloween, no family Christmas, and they even warn on using public transport.

So sad. Yet they do so well in LCHF

Judith Johnson said...

This is Heather Cox Richardson’s column today about the resurgence of Covid 19 in US. She has some comments about the Great Barrington Declaration that I found sobering. https://heathercoxrichardson.substack.com/p/october-13-2020

Eric said...

Some Swedish news in English:
https://www.thelocal.se/20201013/sweden-opens-doors-to-local-coronavirus-guidelines-as-cases-pass-100000

https://www.thelocal.se/20201011/sweden-risks-1000-more-covid-deaths-this-year-maths-prof

Eric said...

Judith, your Link seems to be broken

Peter said...

Hi LeenaS, I can understand your sentiment because yes, Sweden did very badly in the early days. Nothing like as badly as the UK did or as badly as New York did, though I’ve not really followed exactly what was done to nursing home residents in the latter.

It still leaves the question of what to do now and what do we wish to achieve.

Judith, I look at this from outside the politics. Let’s image next year’s vaccine arrives today in massive bulk. Imagine it will protect six out of ten young healthy individuals from becoming PCR positive for at least 2 months. It has never been tested in the over 80s but, if it is as good as the influenza vaccine, it probably won’t do much to protect them.

So four out of 10 vaccinated healthy people will still carry and excrete the virus and elderly people probably won’t be protected. When might anyone open up a locked-down country on the basis of this vaccine? Imagine you can deliver the vaccine to the whole country through next week.

Numbers of cases and numbers of deaths are disingenuous. There are a lot of people in the USA. If 0.1% of them die, that’s an awful lot of people which is simultaneously combined with a very low case fatality rate. It’s currently 666/million, hardly a world leader for COVID-19 losses. Obviously the population fatality rate will slowly rise because more people will still die and the population is relatively fixed. Personally I would expect the USA to eventually end up with one of the highest population fatality rates simply because America is the poster-boy for metabolic syndrome, it is their gift to the rest of the world.

Eric, having listened to the RCPath webinar about the post mortem findings from patients who died of SARS-CoV-2 this does not surprise me. No one would claim that this is a trivial disease. Long-COVID is not exactly surprising either. The discussion is what to do in order to limit the overall impact…

Peter

baggirl said...

Count me in. I've read the credentials of the authors and co-signers: they have more data, more data analysis tools, more data experience, more time examining the data, more knowledge of epidemiology trends, more risk/benefit knowledge, "more" reputation on the line, etc, than anyone posting here. I know experts can be wrong, but I doubt they are more wrong than the politicians, who never considered the unintended consequences. Covid is demonstratively a risk for certain groups, not the entire global population.

Kajus said...

https://www.youtube.com/watch?v=GSQImPTY81E
This was good, will be listening now for the second time -Thank you so much Peter and Paul.

Stefan said...

I'm half way at the moment. Thank you for doing this Peter, I really enjoy it :)

cavenewt said...

Hey folks, what Kajus and Stefan referred to above is a 2-hour interview:

"Is it saturated fat or polyunsaturated fat that’s killing you? Peter Dobromylskyj from Hyperlipid" with Paul Saladino, MD.

Peter said...

Hi cave, Stefan and Kajus, I'll put a link up to it as a new post. I've only had chance to listen to about half but it sounds like me I guess!

Hi baggirl, to me it's more that their message makes sense, credentials are less important. Their biggest problem is the unimaginable amount of money that has been spent on lockdowns and pre-purchase of vaccines. Very few governments can back down from this degree of financial and face investment.

Peter

Peter said...

BTW, I had a lot of sympathy for Chris Witty in the early days. That's gone now...

Peter

Passthecream said...

Peter it's nice to be able to put a voice to your writings.

On the vaccine topic, wrt fluvax I always thought that it didn't stop people getting the flu but made it much less severe and minimised the transmission of it, to greatly lower the R value but not to zero even amongst the vaccinated. Now I'm older that is even more likely because it is ineffective unless they load it up with extra adjuvant.

What that means in relation to CV vaccines I do not know but it suggests that CV won't be eliminated any time soon.

NerdMom said...

Peter,
Do you accept emails from random people across the world? I don’t see an email account listed. I have a question on a different topic that I’d like to ask your help with.
Thanks!

Eric said...

Brand new and not yet peer reviewed (and from my alma mater, too):
https://arxiv.org/pdf/2009.05732.pdf

This is from a group of mostly theoretical physicists who usually model complex materials.

Just by breaking down infection rates by age group and using age dependent infection fatality rates, they were able to model deaths in Germany. Their key findings:
- actual fatalities match prediction very well
- there is no indication that detected infections are harmless now
- nor that a major percentage of infections is currently not being detected
- elder cohorts were well protected into September which is when higher infection rates in younger cohorts started spilling over
- if trend continues, will see 200-300 deaths / week in Germany by end of October, i.e. half of what it was beginning of May

Eric said...

Another paper from that group explaining their model:
https://arxiv.org/pdf/2009.05732.pdf

Eric said...

Sorry, this is the newer paper that I meant to post two posts above:
https://arxiv.org/pdf/2010.05850.pdf

Jay said...

Eric,
Sorry what do you or they? mean by the second key finding
"there is no indication that detected infections are harmless now"
Harmless in what sense - to the individual, for spreading?
And given that it's a modelling paper (I did look at it trying to find the answer to my query) surely anything about whether detected cases are 'harmful' or not is an assumption in the model. As far as I can see they implicitly assume 'hidden' infections are contagious but I'm not sure we really know that.
Jacqueline

Eric said...

Jacqueline, my summary is for the paper dated Oct 13 that I only posted later - sorry.

Harmless were my words and maybe too abbreviated. What they found is that cases detected by PCR translate into real deaths at historical rates, in contrast to all that talk that PCR is picking up lots of harmless cases because it is overly sensitive.

And the main takeaway is that once you have increased prevalence in younger people, it becomes difficult to protect the elderly.

Frunobulax said...

Peter, I disagree here.

My first point is that we look way too much at death rates. From what I hear, up to 1 out of 10 surviving patients (including many young ones) have long-term symptoms. Many of them could be permmanently unable to work with severe fatigue (like Myalgic Encephalomyelitis/CFS) and even in need of permanent care. If we allow infection of most of the young people, how many do we condemn to wasting away the rest of their lives?

Second point: I wonder why the "flatten the curve" argument is lost somehow. Coming from Germany, where ICUs were full but in the end everybody with COVID19 became good treatment, I can't help but wonder what would happen to death rates if infection rates rise to a point where most of the patients wouldn't get adequate treatment. Obviously we're juggling with probabilities here, but isn't there a significant possibility that death rates will go up sharply if infection rates rise above what we have seen in spring? Yes, there is also a chance that almost all casualties will be from people "whose time was up anyway", but I'm not a gambling man. I prefer to err on the side of caution.

I disagree with Ivor Cummings as well, who's a proponent of "lockdown doesn't work". The lockdown in spring was very efficient here. Infection rates were cut to 10% within 6 weeks or so. Now, despite the vast majority wearing masks we have a mighty new wave rolling. Seems to me as if a lockdown is much, much more efficient than only social distancing and masks.

Eric said...

Fruno, mostly agree with you. However, where I side with Peter and Malcolm is that we can't protect a majority of the population for maybe another year (as you cannot vaccinate everyone immediately, and the vaccine might not be all that effective) so we'll have those long haulers anyway. Where I differ is in that, as you also suggest, we shouldn't let it roll but slow it down to a rate where neither the health system nor testing and tracking get overwhelmed.

It is interesting to watch that when new infections reach the current warning threshold of 35 new infection / week and 100,000 inhabitants, some counties or cities are able to tamp it down again and some are not. Once you get to 100, you might need a local lockdown to get things under control again.

baggirl said...

What I find curious is that a lot of commenters here seem to think that the scientists and drs who originated / signed this petition don't know all of your points, haven't considered them, dismissed them, whatever.

Frunobulax said...

@baggirl If they did then they certainly didn't adress them in public. I absolutely have lost any trust in authority that I once had. If someone wants to convince me, he has to do it scientifically.

@Eric I agree. And I am highly critical of some measures. For example we now have a 10pm curtain call for bars and restaurants (which just leads to people continuing to eat and drink privately, without sanitation concepts).

But seems to me that the persistence on "wear masks and all will be good" may be ill-placed faith (in fact it reminds me a bit of "eat less and exercise more"), and we'll have to employ some out-of-the-box thinking if we want to prevent a nuclear option (lockdown). For example, I've recently read an argument that it would help a lot if everybody simply kept a diary, noting whenever she/he was in the vicinity of other people for more than a few minutes (meeting, restaurant, party). Apparently a big problem is that many infected people often don't remember what they did a week ago, so we can't trace contacts and send them to quarantine. More promising (to me) seems the concept of devices that eliminates the virus from the air (I think UV light but I'm not sure), that could be installed wherever several people share a room. That would be independent of individual compliance to rules, and keeping the windows open in schools and offices isn't too sexy if it's freezing outside.

If everything else fails, a limited lockdown (say 3 weeks), perhaps restricted to certain cities/states, may reduce cases sufficiently to buy us another 2-3 months.

Of course the main problem could be that this topic is way too difficult to handle in 160 characters, which seems to be the default attention span for many people nowadays. It could be that the virus mutates rapidly enough that there is neither herd immunity nor effective vaccination...

Justin said...

UV air treatment in forced air systems and especially fresh air vintilators are a no brainer. I'm going to put the fresh air ventilators on my systems at home. Need to look into the UV treatment and viruses.
I should have done it a long time ago. Because of the big push for green building, buildings are built so much tighter these days. There isn't as much fresh air infiltration.

cavenewt said...

Frunobulax said 'I wonder why the "flatten the curve" argument is lost somehow.'

My question also. That was the argument early on for lockdowns, to smooth out the burden on medical facilities. But at least here in the US, the message seems to have morphed into "prevent all possible infections no matter what."

Whether or not I agree with that — and I am assiduous about social distancing and wearing a mask, at least partly because these days it's a political statement — it appears that we're doing the herd immunity thing no matter what.

Eric said...

Justin, make sure you have a heat exchanger if you go for fresh air. I've had a system like that for 10 years and wouldn't want to do without.

But you really don't have to worry about the virus at home unless you invite infected people in.

Peter said...

Hi Pass, yes, I don’t see the virus being eliminated at all. Too late for that now. Happily it appears to have a predilection for people with metabolic syndrome, one of the easiest problems to side step.

NerdMom, it’s on the blog where it says view my complete profile

Eric, yes, that second paper suggests, correctly I feel, that deaths will increase in the elderly. Certainly in the UK I see no concerted effort to control infection in the elderly, pretty much as you would expect when your track and trace system fell off the back of a lorry. Targeted protection seems sensible but currently totally ineffective in the UK.

Frunobulax, as always, yes, disagreement is fine. You might find the RCPath webinar on post mortem findings in COVID-19 patients interesting. https://www.youtube.com/watch?v=5-79monXsJ8. To imagine there are no long term effects is inconceivable. But should we lock down to prevent this, assuming the vaccine will be as good as the influenza vaccine?

Oh, and do both COVID and long COVID still preferentially affect metabolic syndrome victims? Bearing in mind Kraft’s concept of diabetes-situ for 10-15 years being normal before you get the “label” of diabetes. How many long COVID patients are victims of the lipid hypothesis?

My own feeling is that lockdowns are an excellent way to delay ITU admissions. So yes, they might reduce the risk of your not getting a ventilator should you need one. But this never happened in the UK during the initial pandemic, even in London. Bear in mind that we have long, hard ethical considerations to decide who is or is not eligible for admission to the ITU. It has never been open access. You should not put a person on to a ventilator unless they are likely to be weanable post treatment or have a quality of life which is adequate to justify such a huge intervention. This is a stark but very difficult life and death decision and ITU clinicians have faced these problems every day since ITUs were developed.

cave, yes, the UK is likewise on a track to herd immunity due to failure to suppress in the early days. This was probably set in stone by the Cheltenham Gold Cup and the gradual introduction of minimally effective measures until the March lockdown. The virus was well out of the bag by then in the UK. I don’t see it going back in any time in the future. I would also be curious as to the ITU admission rate of supermarket workers. As a group I do not get the impression they are, as a group, particularly metabolically health and they worked right through…

Peter

Justin said...

Eric, have some Honeywell 24v ac adjustable powered dampers at work that I'm not using. Was just going to plumb them into the return side of the heat pump and furnace before the media filter. My girls start back to two days a week of in school instruction and have already started cheer practice a month ago. They are pretty much around kids 6 out of 7 nights a week, so they are keeping that immune system primed and exercised. That's the one thing I worry about with the young people with healthy immune systems. I feel like they need to continually get that exposure.

I'm not worried about Covid, as I feel like we already had it back in March and we are all in pretty good health. Before I knew better, I had my wife do an antibody test and it came back negative. She had the worse symptoms, so I figured it was worth it. Should have just had her get the PCR and see if they would share the number of cycles required.

Justin said...

Btw Peter, that interview is top shelf. Makes me want to dig out my old physiology/exercise phys books. I love mechanistic metal masterb... Lol!

Frunobulax said...

Peter, I have conjectured in the past that most severe COVID victims might come from thrombosis. There was a mini-study a long time ago where 9 out of 12 COVID death victim had a thrombus in one vital organ. I wonder. Do many severe cases come from a thrombus in a less vital organ? Many ICU patients appear to develop kidney failure, but I haven't found a study looking for a thrombus in the kidneys.

The death rate by age correlates VERY much with the CAC score distribution by age. Coincidence? I do believe that low carb, low omega-6 diet is the best prevention. Not to avoid infection, but to increase survival chances.

And for the record, I did a blog post on Diabetes in situ just 2 days ago ;), in German. Nobody knows the Kraft test over here, unfortunately. https://fettfreun.de/diabetes-in-situ (https://fettfreun.de/diabetes-in-situ) I'd figure metabolic syndrome knocks off 10 years from life expectancy on average. COVID19 isn't even in the same ballpark, even if everybody gets infected.

Eric said...

Justin, not sure I understand what kind of plumbing you want to do. I was talking about one of these:
https://www.energiesparen-im-haushalt.de/energie/storage/sites/waermetauscher.html

It consists of a stack of aluminum sheets that keep exhaust and intake air separate, but pull the heat from whichever stream is warmer. In winter, the intake air comes in at about 17°C, so does not need further heating (we usally heat through hot water coils buried in the floor. It comes with two fans that keep the inside at a tad lower pressure than the outside to keep moisture from diffusing into the walls.

Peter, Fruno: what makes you so sure metabolic syndrome is what makes people susceptible? Yes, I have seen the statistics about obesity. The correlation is there but not super strong. Yes, there are thin fat people but they are not singled out in the statistics.

Frunobulax said...

Eric, can't say I'm sure, but I think it's a pretty strong conjecture. Mostly because all the risk factors for becoming a severe case correlate almost exactly with the risk factors for atherosclerosis, which is driven by metabolic syndrome. And blood coagulation appears to be the driving cause for deaths and perhaps for severe damage.

All the explainations that I've read why there is such a strong exponential growth in mortality with age don't convince me. If it would be due to a weaker immune system, children should be very vulnerable. If it's to the flexibility/memory of T-cells, why would a 70yo have a 10-fold risk compared to a 50yo (or whatever the relation is)? But one of the few things that have a very similar distribution is CAC scores.

Look at figure 4 in https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.105.580696 for CAC scores. Almost zero for 50 and below, then exponential growth.
Compare to the death rates for COVID (for example https://www.businessinsider.com/coronavirus-death-rate-by-age-countries-2020-3?r=DE&IR=T#like-other-viruses-covid-19-doesnt-affect-all-patients-equally-2
Almost perfect correlation.


As far as the other discussion, I forgot to mention one thing: If your ITT intervention isn't working, you should always question both the intervention and the compliance. Yet it appears we automatically assume that it must be the compliance. Here in Germany I see very good compliance to mask wearing (with some exceptions), and yet the intervention is clearly not working. Now they ask us to wear masks even outside, if we're not in a crowded space. Really? All we get is "wear your mask and you'll be fine". Please do show me a study that the usual masks (be it the selfmade masks mostly used here or the surgery masks where a good deal of air escapes at the side) do stop the virus from spreading. I'd like to see that.

Passthecream said...

Frunobulax, that's a fairly old article and it brings home just how much the numbers have blown up since March.

I can't find any good vit D status vs age data right at this moment but for quite some time osteomalacia has been a problem in the elderly and now mostly thought to be related to both an inadequate D intake plus inadequate sunlight combined with a declining ability to synthesise vitD in aging skin. If I was looking for something which ties CAC, bad nutrition, age, sunlight avoidance and the conditions in aged care accommodation together, I think vitamin D status might be it.

Most of the bad diet choices associated with metabolic syndrome have an adverse effect on vit D status. Add to that sunlight avoidance, a 'healthy' whole grain diet with hearthealthypolyunsaturates and cholesterol lowering drugs and whacko, there you have it.

Eric said...

Pass, I am not so bullish on Vitamin D as I used to be. Reason: several countries in the Southern hemisphere or near the equator were hit hard, and I don't think all of them have a culture of sun avoidance.

Eric said...

Fruno, Peter: Lockdowns and not-really-lockdowns like we had in Germany worked wonders to put the virus back in the bag, at a time when real infection rates were probably higher than today because of insufficient testing.

So with all the protocols in place and mask wearing and some background immunity, we should be able to pull it off again with less severe restrictions.

So why are tightened mask rules not working?

I am very sceptical that mask wearing outside helps except in situations where people are really shoulder to shoulder. There should be no worries about aerosols outside, and if folks are wearing their masks properly, droplets from sneezes and coughs should get caught.

We keep hearing that private parties, bars, night clubs are a problem. That is probably true.

I wonder why regional politicians in Germany in the current round of tightening restrictions are very liberal with mask mandates for outside (interestingly, often from 7 am to 10 pm only) but very reluctant to close restaurants, at the most intrucing 10 pm closing times, e.g. in Berlin. A few weeks ago people were drinking and dining outside without distancing between tables being properly enforced. Now you can see them packed into tiny restaurants with tables so close the waiters can barely squeeze behind the guests' backs. Same thing for gyms. Just walking through Ulm two weeks ago, I could see full spinning or dance studios with a window cracked for ventilation.

If aerosols are really the problem, they should close restaurants and gyms for two weeks, problem solved. They are already doing that in France and Belgium. Let's see if that helps.

Passthecream said...

Eric, I think it is possible even for fair skinned people living in the higher latitudes to get all the sun they need for adequate vitD in about 15 to 20 minutes in the sunnier months but if locked inside, eating the wrong stuff and especially if following modern dietary and medical advice that can go horribly wrong. However, I'm sure this is a multifactorial epidemic of which vitD is only one factor. Humidity and airconditioning may be other factors, crowding, and ?????

There is one study which finds that susceptibility to this bug is strongly correlated with genetic factors which have their highest rates of expression in Pakistan and some other Asian and tropical countries, and Western Europe.

Passthecream said...
This comment has been removed by the author.
Passthecream said...

I'm sure you will have already seen this reported in several newspapers. Another unreviewed paper: https://www.nature.com/articles/s41586-020-2818-3

Frunobulax said...

@Passthecream Is there a "biomechanical" explaination why vitD deficiency would cause organ failure and the like? With atherosclerotic plaques we have one: COVID19 increases inflammation, which in turn causes blood thrombi to form. These may wander around and restrict blood vessels somewhere in the body. If it happens in a vital organ, the patient dies. Autopsies seem to confirm this.
vitD deficiency would contribute to that process (as it's an antioxidant), but it would be only a voice in the choir (even though perhaps a loud one).

Also I'd expect vitD levels to be higher now (with summer behind us) than they were in March. Maybe this explains partially why mortality rates seem to have dipped a bit. (Along with the obvious other factors, like more experience, anticoagulants, Remdesivir etc.)

Justin said...

Eric, that is a much more expensive and efficient setup than what I was going to do. The heat recovery units are awesome. I would love to have radiant floor heating like you have one day. I harvest a lot of oak on my property from down trees and would love to have an indoor wood boiler with at least 1000 gallons of storage. It would be nice to just slap a coil in my hvac system to use that heat and a liquid to liquid to heat the water.

Passthecream said...

Frunobulax, there are many papers and articles about the 'Bradykinin Hypothesis' at the moment where vitamin D has a complex role to play in a massively disregulated RAS. I think that will give you a good biomechanical explanation.

A few quick links:

https://www.forbes.com/sites/jackierocheleau/2020/10/02/the-bradykinin-hypothesis-what-it-is-and-what-it-can-tell-us/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267506/

https://elifesciences.org/articles/59177


In my hemisphere(?) we are heading the other way atm, it is currently mid spring but government interventions have been very effective here since April, with quarantining, initially closures of bars, sports venues and restaurants, border closures etc, and even the adjacent state of Victoria has managed to drop it's "second wave" infection rate from a peak of 700 cases per day down to 1 to 5 over a few weeks of extremely strict controls to the point where they are now relaxing the restrictions as we head into much warmer and drier weather. There was no mandatory mask wearing back in April-June. I think it has now become mandatory in NSW and Vic. to wear them in public or at least strongly recommended. Individual states vary and I can't keep up with it. Not many people are wearing masks where I live since there is no community transmission.

Passthecream said...

Frun: Karl pointed this one out a while back

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/


When you view that result in terms of the Bradykinin hypothesis, it looks like the vitD supplementation as a treatment is significant by not allowing plasma D levels to drop thereby increasing RAS disregulation. It adds up. As to whether the D status of an uninfected person is prophylactic - different question. Some reserves might be good to have?

Eric said...

Another article in the guardian, similar to the one I linked previously:
https://www.theguardian.com/commentisfree/2020/oct/18/covid-herd-immunity-funding-bad-science-anti-lockdown

cavenewt said...

Everything is becoming so politicized these days. I've pretty much given up hope for humanity. The sad thing is we're taking so many other species down with us.

Eric said...

Justin, those heat exchangers run a few 100 Euros on ebay, either used or offered for the diy market. A whole heat recovery unit, i.e. with fans and control logic, starts at 1000 Euros.

Frunobulax said...

@passthecream Interesting, thanks. I heard in passing about the Bradykinin hypothesis but didn't catch the vitamin D reference. I'm a big proponent of vitD for other reasons, last time I had it measured my value went off the scale. All the lab could say was "over 150" :)

Passthecream said...

Cavenewt, everything has been politicised for quite some time just not so much that it interferes so blatantly with everyday life as now. You do what you can ... I have been through some dark days this year. the cv pandemic is my second apocalypse in the last twelve months after the massive bushfires here (Southern Aus.) which came within metres of my house, and the two or three weeks after that were touch and go but everything has greened up again better than ever and I am still hangin' in and I hope you do too!!! I think I owe my sanity to people like Peter who keep my brain ticking over.

Eric said...

https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

Apparently, a most Covid19 survivors have heart damage and ongoing myocardial inflammation irrespective of severity and preexisting conditions. I had not even heard of CMR technique before this.

Justin said...

Eric, that's definitely reasonable. I'll have to look into them. Thanks for the info!

cavenewt said...

Pass, thanks for the pep talk. I've lived my entire adult life in the two most conservative American states, so I understand about politicization!

I really feel for you with the fires – I donated money to a couple of Australian wildlife rescue operations. Our annual fire season here have been getting worse and worse but nothing like what Australia endured last year. I hope it's better this year.

Peter said...

Eric,

I'm not sure an opinion piece in the Grauniad is anything I would choose to base a decision of any sort on. I have no doubt that SARS-CoV-2 does a lot of damage. I'm equally sure a medic would not recognise metabolic syndrome if it bit them on the butt. Epstein-Barr virus can be nasty too if you're unlucky. I'm not keen on lockdown/test/track/isolate to control that virus either...

Peter

Bob said...

"Epstein-Barr virus can be nasty too if you're unlucky."

Yes. Some forty years ago I knew someone who was struck with Guillain-Barre syndrome, and it was blamed (rightly or wrongly, who knows in 1979) on an Epstein-Barr infection. Yes, it was nasty.

baggirl said...

credit to Dr. Mercola for posting this:
Psychiatry professor Albert Biderman’s “CHART OF COERSION”:

Isolation techniques — Quarantines, social distancing, isolation from loved ones and solitary confinement

Monopolization of perception — Monopolizing the 24/7 news cycle, censoring dissenting views and creating barren environments by closing bars, gyms and restaurants

Degradation techniques — Berating, shaming people (or even physically attacking) those who refuse to wear masks or social distance, or generally choose freedom over fear

Induced debility — Being forced to stay at home and not be able to exercise or socialize

Threats — Threatening with the removal of your children, prolonged quarantine, closing of your business, fines for noncompliance with mask and social distancing rules, forced vaccination and so on

Demonstrating omnipotence/omniscience — Shutting down the whole world, claiming scientific and medical authority

Enforcing trivial demands — Examples include family members being forced to stand 6 feet apart at the bank even though they arrived together in the same car, having to wear a mask when you walk into a restaurant, even though you can remove it as soon as you sit down, or having to wear a mask when walking alone on the beach

Occasional indulgence — Reopening some stores and restaurants but only at a certain capacity, for example. Part of the coercion plan is that indulgences are always taken away again, though, and they’re already saying we may have to shut down the world again this fall

Peter said...

Hi baggirl, It's an interesting idea but here in the UK it feels like utter, overwhelming incompetence. We chose this very decisively, very recently. We get what we asked for.

Peter